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F
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R
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AS A
FREDERIC
REPRESENTATIVE FROM FLORIDA
MEDICAL COMMISSION ; MEMBER
OP BOARD OF MANAGERS
AMERIOAN NEUROLOGICAL]
OF WOMEN AND CHIL
HONORARY MEMBER
SOCIETY; CORRl
MIDICO-LEGOA
LENTE,
A.M.
ON THE EXECUTIVE COMMITTEE OF THE CENTENNIAL
R Or THE AMERICAN PUBLIC-HEALTH ASSOCIATION;
OP HUDSON RIVER STATE HOSPITAL ; OF THE
L ASSOCIATION; LATE PROFESBOR OF DISEASES
DREN IN THE UNIVERSITY OF NEW YORK;
R OF NORTH CAROLINA STATE MEDICAL
IBPONDING MEMBER O NEW YORK
L SOCIETY; VICE-PRESIDENT NEW
YORK NEUROLOGICAL SOCIETY, ETC.
[REPRINTED FROM THE NEW YORK MEDICAL JOtURNAL, NOV., 1876.]
NEW
YORK
rut*
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, M. D.,
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FLORIDA
,w
/'%
HEALTH-RESORT.
Fox
years
a phthisical
embarrassing
the question, Where sha
or phthisically-inclined
one
to the
physician.
II I spend the winter ?
patient, has
Winter resorts, some of
them entirely dissimilar in the characteristics of their climate,
have risen or fallen in the estimation of the public, and, to
some extent, among medical men, according to the prevalence
or decline of a theory, or apparently even a fashion; and we
are still, to a great extent, at sea as to what is the most favor-
able
location
whether any
an invalid
change is desirable.
winter or
spring,
The cold and dry regions,
reio r
e. g., Minnesota; the elevated regions, with their rarefied air,
e. g., the Engadine in Europe, the mountains of Peru in South
America, Laramie and Colorado in this country, have had their
pilgrims, and neither theory nor fashion seems to sustain their
reputation. The til
many years, absorb
lately fallen greatly
me-honored resorts of Italy, which, for so
ed almost
in the
the entire ii
estimation of
invalid travel, have
intelligent people,
who could not fail, after the charm of novelty and the haze of
romance had been dispelled, to see on how unstable a founda-
tion, in a climatic and hygienic point of view, her reputation
- Ii
been
based.
forts of Bennett,
Even Mentone, to
for a
long
series of
which the name and ef-
years, gave a fictitious
< a' ^ 't -E '
r^ IF '
- ^-
II
4^ :?.-
e^ ^--
< ~ ~ ~ f A' ^ '
been an
or even
m
prominence as a health-resort, and rendered it, for the English
invalids
least, a medical Mecca, has failed to respond satis-
factorily to the test of time and experience.
One who wishes
to get a thorough eypoeb of the peculiarities of Italian climate,
from a responsible source, should consult the entertaining book
of Dr.
Bermud
James Johnson on Change of Air."
la
through
s lately
efforts of
'been
recalled
a transportation
The climate of
some
prominence
company;
those
who
have remained there for a few weeks have been more in-
jured
than
benefited.
Those
who
merely
made the voyage,
and remained but a week or two, have seemed to be somewhat
improved in health.
little
been
known among our people concerning
climate of Florida.
Comparatively
visited the
State
long
prior to
Seminole
war.
War
Many causes conspired to this
unsettled
state of
affairs for many
years after; the impossibility of securing any decent accommo-
dation for invalids
then the civil war checked travel and immi-
gration, and rendered the State still a terra incognita.
Now,
everything has
there, especially
changed.
one
who
paid a visit
John's River region, for three or
four years, it is as if the magician's wand had been waved over
Not only
those
seeking health, but settlers, in the shape
of farmers, of men of means, even of wealth, of education, and
refinement
, have been pouring in along the river counties;
many
as twelve
thousand
have
been
estimated as the influx
into
Orange County alone
in twelve
months.
Forests have
been leveled.
Orange-groves have taken their places.
Schools
and
ety
-few
churches have sprung up, and refined and agreeable soci-
can
short
be found over a large extent of country,
t years ago a howling wilderness existed.
here but a
The tide
of invalid travel having been diverted from its usual channels
this favored
spot, the attention of
the medical profession
has naturally
been attracted there also, and a growing desire
has been manifested to secure reliable and definite information
in place of the various conflicting reports which are constantly
flooding thi
Journals
collected
and magazines of
coun try.
The
a large amount of valuable infarmtiom
aana kaA
naudjalIw nnnanAAu Rae n.AlUabba ab
writ
*n^ a4
mI qIY~
r
is
4
S'
* '
the suggestion of friends and physicians, a somewhat elaborate
account of the climate, remarkable objects of interest, and re-
sources of Florida,- especially as a health-resort, when he found
that he was overtaxing his available time and health, and now
offers, as a
thinks
poor
substitute, such
may prove
interesting
remarks and suggestions as
or serviceable to the profes-
81on
for which he may be able to find room in the some-
what restricted compass of a medical journal.
The discussion of the broad question of
rlous
climate, in its va-
aspects and bearings, has always been a perplexing one.
It is especially so when we, as physicians, come to consider it
in its relations
to any particular individual,
or even any par-
ticular
which
disease.
analyze
we are confronted
mass
information
with
, to scrutinize the various conflicting
statements of equally
thing
reliable
a definite and
observers, and
satisfactory conclusion,
to deduce any-
with regard
to any particular
difficulty. To th
locality
sort of
or country, is a matter of no small
investigation
writer
dressed himself for the past two years, in the case of Florida;
and indeed, for the most part, only to a small portion of the
peninsula, that
which is most accessible to invalids.
For, un-
proper facilities for easy travel and proper accommodation
are provided for those
larger portions
lying along the Indian
River, and
along the Gulf
coast, south of Tampa,
which
supposed by many to present attractions superior to the more
northern
portions, their relative merits may profitably be left
out of the
question.
The great bulk of tourists and invalids
have
heretofore
distributed
themselves along the St.
John's
River and
at St. Augustine.
A few go into the pine-regions
of the interior to get away from the river.
will in Florida, it
tion of the count
bodies of water.
But, go where one
s diMcult, owing to the peculiar conforma-
;ry, to escape
influence
With reference to Florida,
considerable
"almost without
a metaphor," says "Chambers's Encyclopaedia," "it may be de-
scribed as. amphibious." T
disadvantage, constitutes, to
his, however, so far from being a
a certain
extent, its charm, and
will, in
the future, constitute a
great source 'of
its wealth-
L. -- -t-_ t- --- --.- A.L ____ _- ... -1- A.. .-.
are
rl ,,,
1
.* -".
*4 ,I
crystal lakes.
A study of most of the works on Florida,
from
that of Le
Moyne,
who
visited the territory as artist to
French
Bartrams,
expedition
who
under
Laudonniire
visited it as naturalists
in 1564, and the
1772, to the latest
publications,
ificluding periodicals,
pamphlets,
newspa-
pers; access to all the records bearing upon the subject in the
possession of the War Department, the library of the Surgeon-
General, and other .depositories in
Washington;
a careful col-
nation of
the various meteorological and other tables included
in these records
personal interviews with distinguished medi-
cal officers of the army,
who have served in all parts of
Flor-
ida, and
with
many of the scientific and medical residents of
State,
with some of 'her representatives in Congress; and,
lastly, the opportunity for consulting a considerable
number
thousands
intelligent
visitors
and invalids,
who
passed through, or located for the season at the writer's winter
residence, have afforded
the intricacies of the
him unusual facilities for unraveling
subject
so graphically
described
Scoresby Jackson.
the relative
The last source of information, as regards
merits of various climates, he considers of more
value than all the others, more so than even an extended
sonal
observation.
For invalids are by far the best judges of
climate; they are living barometers and hygroneters.
Here,
you have
the. opportunity
to question and cross-question the
reporters, and not only
thus to arrive at the truth, but,
what
books
seldom
give, the
whole
truth.
All of these indi-
viduals
were intelligent and
educated
people, most of them
invalids who had traveled the world over in search of health,
and tested its renowned sanitary resorts, some of them winter
after winter. Few of them had any *particular prejudice for
or against any special locality, save from its actual effect, but
were, from self-interest, in search of
the best.
The evidence of those who have tested the climate of Flor-
ida by sufficient personal
nation of the data furnish
favortble character. The
a few aeke to roamning from one
I AI -- -
observation, or by a careful exami-
ed by others, has been of the most
opinion of those who have devoted
locality to oanber, or who
_ A-% u l..- ...
S, *
* *J-%,
4
may be profitably neglected. .From the very earliest discovery
of the continent, the remarkable salubrity of the climate, and
the extraordinary transparency and purity of the springs, gave
origin
tradition
that a
"fountain of
youth "
existed
I
somewhere within the borders of the territory, and led to the
expedition of the romantic and chivalric De Leon in search of
it. The first impression of a visitor, who has been led to form
a picture
Florida
from
enthusiastic
descriptions
writers,
part, is
aided,
not
perhaps, by a
unfrequently
vivid
that
imagination
on his
own
disappointment.
longer acquaintance almost always leads to a revulsion of sen-
timent, and a succession of visits to something of the enthusi-
asm of the earlier historians.
able data with
regard
to the
A reasonable amount of valu-
meteorology of Florida is sup-
plied by the volumes of the "Medical Statistics of the United
States Army;"
a sanitary point
but if one undertakes to judge of a climate, in
view, .or
fitness of
any particular
country or district for invalids, by mere
latitude or tempera-
ture, or its variability or invariability, its dryness or humidity,
he will fail to comprehend the philosophy of the subject. Its
geography, especially its physical geography, must be studied,
its position with regard to surrounding or neighboring seas or
bodies of water, to great currents both of air and water, to its
relation
storm-centres
tracks of
storms, to mountain-
ranges, not
only within
its own borders, but. sometimes at a
distance from them.
Thus Florida has often been
poetically
described as
"the
runs through the so
Italy of America," yet the parallel which
nthern extremity of the peninsula is 25,
while the southern extremity of Italy is 380. The
440, and the Isle of Wight and Torquay nearly 51
Riviera is
,; yet the
winter climate of the latter is very pleasant, and highly recom-
mended in England for consumptives.
While one can usually
live in perfect comfort in Florida, even away from
if at rest in the shade, under a temperature of 95
the coast,
the same
person
would
fort.
under
L,
a like temperature
New
probably be in a state of mental and
York
or Canada,
physical discom-
It is the insular position*of Florida, withbthe proximity
d.the Gulf Stream flowing north, and the cold arctic current
S' '
-l -
, .4
:. :,
r~W~
flowing south, the comparatively narrow strip of country Mq-
rating the Atlantid and
the Gulf, and
the .numerous snfalter
bodies of
prevailing
water
winds
abundantly distributed
over its surface, the
always sweeping over water
a unifortt
temperature, which modifies the heat of summer and the cold
of winter. The peculiar character of the climate,"' says br.
Robert Southgate (" United States Army Medical Report"),
"consists less in the mean annual tern neramtnr than in thA
manner of its distribution
an insular clin
modified; althc
47 73' colder t
place is only 80
nate,
- II- .
- -. r K V..
throughout
extremes
nugh the winter at Fort
han
at Tampa
warmer.
Bay,
year.
temperature
v flbu a -
Possessing
are much
Selling, Minnesota, is
t summer at the latter
-In the summer season, the mer-
cury rises
higher
in any portion of
United
States, and
even in Can
"Within the
ada,
than
period of
does
along the coast of Florida."
six years," says Forry,
"the mercury
at Key West was never known to rise higher than 900 Fabr., or
lower than 44 Fahr." The variabiity of the winter tempera-
ture has frequently been noticed, and has been often alluded
to, by those who have not had personal experience of the actual
effects of these
changes
on the
human
system, or with
modifying influence on these changes of the peculiar constitu-
tion and surroundings of the State, many of which have al-
ready been pointed out, as greatly detracting fiom its value as
a health-resort.
A change in twelve hours, for instance, from
70 to 60 or 50, has a very different effect on the sick from
a change of
or Chicago.
a like number of degrees in Boston, New York,
Practically, these variations are of actual benefit
to those invalids who are
tolerably careful,
and who take the
precaution to change clothing with the change of temperature.
A continuous temperature of from 75 to 800 at mid-day, for
a number of consecutive days, is generally felt as a serious in-
bonvenience, especially by the more advanced and debilitated
Omes
phthisis,
these
generally
longed
for-the cold
perience
6eange, knowing by ex
the .ed4 heat of some
dv'ev hbih. and very am ble
their' tonic
effect,
where
troppal regions, though not oexs-
-.
moat unmnn_ t aienrlv
I__ _Cl
*
valids.
With regard
these variations of temperature, Dr.
Southgate remarks,
"Rarely is the change seo
great as to imi-
prees the individual in fair health, uncomfortably, and the in-
valid has
invariably sufficient warning to guard
against it."
Surgeon-General Lawson, United States Army, speaking from
an extended personal experience,
ida is remarkably equable, and
"The climate of Flor-
proverbially agreeable, being
subject
fewer
atmospheric variations, and its atmospheric
ranges much less, than
any other part of
United
States
except a portion of the coast of California."
faults it may have, the climate of Florida, in
With whatever
comparison with
most others, stands
preeminent.
I have watched
with some
anxiety, the
cases of
those
more
advanced stages of
consumption,
when the diurnal
temperature ranged,
as it did
last winter, from December 5th to December 16th,
as follows:
780, 820, 82, 83, 840, 81
, 820, 810, 81
, as I heard them
complaining
from day
day, and
was
gratified,
when
mercury showed
their
690 at
expressions of
the same
relief, and
manner and appearance.
hours
to see
This was an
on the 16th, to hear
their entire change of
unusual series of days
for Florida.in winter;
tion is quite common,
but a high temperature of shorter dnra-
the cool, sometimes
cold,
change
which succeeds, so far from causing colds and pneumonic com-
plications, common
under
circumstances
at the
North,
generally acts like a cold
shower-bath, and braces up the sys-
tern.
The occasional *wood- fires, around
which
invalids
so cozily congregate on the cool days, are
never unacceptable
as a pleasant change, and
contrast
favorably with
more
uniform and debilitating heat and monotony of more tropical
climates.
Nothing, in fact,
is so distasteful
injurious to
most invalids as monotony.
The writer has always believed
in the traditional
idea that when
phthisis
had arrived at
stage of softening, a removal to a warm climate is not a bene-
fioial change, that a sudden and rapid
increase of the trouble
is pretty sure
follow.
A study of
such
cases
w
has not tended to establish the correctness of this idea.
0
inter
On
the contrary, the progress of the disease wa slower, if not en-
. t a J
*^ ^- I *
_I
*I ___ J
-* A ,
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C ^^
-,; ;
r'f' "' S
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V.
, -- .
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they sometimes are) on
their arrival, even with the dieadvan-
tage of being deprived of the comforts of home, which they so
much need.
Every village and
hamlet in
Florida can
prob-
ably furnish its examples of people who have come there years
ago, only, in the opinion of their friends, to die, and who are
noDw doing well,
some of them
apparently in full
health.
is impossible, of course, to say, without a physical examination,
how many'of these were cases of
chronic bronokitis, or other
affections
simulating
phthisis, but
their
history showed
that
they would almost certainly have died except for their change
climate.
This little village, in which I have taken up my
winter abode, can furnish several
that the more uniform heat of ti
examples.
tropical
It is very likely
climates may furnish
stronger evidence of the correctness of this commonly-received
opinion among medical men.
The temperature
similar to
that of
a typical May or
September
in New
York, and
usually delightful.
period
twenty
years,
was
Jacksonville,
on the
John's, for January, February, and March, 62
at St. Angus-
tine, 590
Pilatka, latitude
290 34'
, it was, last winter, for
January, February, March, and April, at 12 x., 680 50'
average temperature, taken during these
The
months every hour,
from 12 at night until 6 A. M.,
was 570 40'
A slight film of
ice is oc asionally seen during the winter, and slight frosts are
not rare north of the 25th parallel, but not often injurious to
vegetation.
Williams, in
history of Florida, speaks of a
snow-storm which appeared in 1774, and
extended
over most
of the
State.
"The
ancient
inhabitants," he
writes,
" still
speak of it as an extraordinary white rain.'"
As regards hygrometric conditions, it is necessary to say a
few words.
The "dampness" of the climate has beep much
talked
about by those who
have
regarded
only the
physical
aspect of tl
everywhere,
of the air.
e State,
without
the large
proportion
any knowledge of the
The air is, during
water existing
actual
0
summer, very damp.
condition
Gans,
surgiB-
instruments,
etc.,
rust
spite of
preantions.
Mam, rain lls durinr this memos than all the othem ammbinLd;
* E, *i- ,^ ^
~
tI^'Qi
S4
,' IL
special precautions necessary to preserve my instruments from
rust, and boots and. shoes, long neglected, showed
no mould.
At some of the prominent reports in Florida the invalid is con-
ecious of an unpleasant dampness after sunset, when out-of-doors
and not in active motion.
As a rule, these places are usually
surrounded
by large
trees, with
their
usual
funereal
adorn-
ments of Spanish moss,
which may, in some measure,
account
for this. At Pilatka, and at other points farther up the river,
it is not so. This village, with an elevation of twenty-five feet,
has a natural drainage on three sides, a
peculiar soil, and
large trees, only the wild-orange, and other tropical
trees of
slight elevation, simply for ornament.
Here,
when the air is
too cool, one
may be
until
or eleven
o'clock at
night with comfort, though
is not advisable for invalids to
exposed
at this
hour.
The
dews, usually heavy, do
commence rt
commencing
gather until
o fall, and
twelve
falling
o'clock
steadily
mercury then
until
or six.
Until 11 P. M., or
later, last
winter, a
handkerchief
could
swept over the grass-which is here, unlike other localities in
the State, as green as in a Northern village in summer-with-
out being
during
moistened.
the day, there
When
mercury rises to 75"
are fogs;
invalid
or 80
rarely
them
, as they commence
midnight, or later, and are diesi-
pated
by the sun
before
their
breakfast-hour.
A great deal
has been said, by those interested in other winter resorts, about
the fogs and dampness along the river;
but there is really no
more dampness than is useful, indeed necessary, to prevent too
rapid
radiation of heat from
surface of the
earth, and a
consequent too rapid tall of temperature.
Were it not for this
provision of the climate, instead of a fall of ten or twelve de-
agrees, we should, perhaps, have one of thirty to forty.
In the
desert of Sahara, for example,
where the dryness
is absolute,
and radiation at night unrestricted, the temperature falls to
the freeoing-point; and on bur Western Plains the difference
between the diurnal and nocturnal temperature is sometimes
600.
Here while the evaporation of moisture during the day
tempen
the heat, the condensation at night limits the cold.
At Fr Xinr. in th. sume
section of
the State as
Pilatka.
"* 4t*~ 1t
-- ^ :. .- I ',.
S,ir
1 1 *w ,
f.,
I 2' 1.'
4 ,'
-- ^ .'
4 b
4, 'a
*
*
Forry gives the annual number of fair days as 809 for a ied
of years, and
on the Northern Lakes 117.
'On the oM d of
Florida the number is 250.
A moist climate is not neceuarily
bad for consumptives, though it is generally so.
On the Nile,
though
most
cases do welr at
Thebes
Cairo, others do
better at Alexandria.
The climate of Lipna is very dry,
consumption is very common, while on the mountains back- of
Lima the air is always damp and
rain common, yet consump-
tion is rare.
and moisture
Cold and
moisture are always bad, but warmthi
may or may not be so.
The question as to the
influence of large bodies of water on the production and prog-
ress of phthisis
contemplating
1s 80
important, especially to those physicians
adoption of Florida
for their patients, that, at the
risk of
as a winter residence
extending' the limits of
this paper unduly, I quote a very instructive table from Forry,'
with an abstract of his remarks on the same, and his
prelimi-
nary observations:
"Having already
demonstrated
that
regions
. United States, on the same parallels of latitude,
teams of climate very diverse in character, viz.-1.
bordering
inland
on the
seas;
ocean
Those
Those
remote
under
from
such
present sys-
The regions
influence of
controlling
powers-it will
seen
that these
laws
climate
main-
an intimate
diseases.
relation
It seems
with
etiology
well-established
pulmonary
r that the
prevalence of
mate,
increases
catarrk and
decreases
inf-uenza,
in each
in proportion
system
as the
seasons
are contracted, thus
maintaining an
unvarying relation
with
the extreme range of the
seasons."
thermometer as connected with the
" The
following
table
. presents,
a condensed
form,
so far as regards the
oatarral
forms of
pulmonic
lesions,
the results of the quarterly
sick-reports of forty-five perma-
nent ports, arranged
classes,
comprising a
period
year :
The Climate of the United State, and its Endemic Influeau, besd
bhidy on the Reoords of the Medieal Department and A4Jutut-Genuaus.
Ofao United State Army. 1849."
tain
ii' I:'1
; -
4 .
S,
* V4
SYSTEMS OF CLIMATE.
1Ft Cma.-Poetaon cot ofN. England.
ld Cs.--Poete on N. chain of lakes..
8d ClMf.-Post remote from the ocean
sed intend eMa.. ......................
1st Ciaw.-Prom DeL Bay to Savannah.
d (OCm-B-outhwestern stations......
SIst caue.-Posta on Lower MI.i lppl.
I d Claa.-Posts in pelnhnla of lorida.
Average.. .....................
48* 18
*wV w
88 61
48 00
l AIO atrani aTD
1,o0 Smwem.
"This table cc
stations, those of 1
"This table,
ratios of each sysl
relations and seqi
etiology of catarrt
ologi6al laws esta
Division, consist
England coast, as
ature, the annual
as low as 233; oni
influence is in ope
acterized by the
ratio of 5562. Bn
and isocheimal li
summer and wini
ame space, press
elimae. As these
nutains, besides the results of the permanent
the thiity-one temporary ports in Florida."
which exhibi
tem of climate
iences, affords
hal
:t
e,
;a
affections as
kblished.
ng ot the 1
the ocean
ratio, treat
the Great
Take,
first
the annual and quarterly
and serves to elncidate their
beautiful illustration of the
Ionnected with the meteor-
for example, the Noathern
bh: eeew
modifies the
ed per 1,00 wl
Lakes, where t
,ration, it is 800; wlifle
extreme range of thi
t let us follow more i
inee representingg the i
her), which describe fAo
nting alternately a
e lines, on the coast of'
- --
. ..-^ ?~1 :^ -
4^^
^ -. ^ *
j
the line of
equal summer rises, and that of winter sinkl, and
the ratio increases proportionally ;
proceeding into the region
of the Lakes, the lines again converge beneath the controlling
power of the waters, and the ratio of
modified accordingly; again advance
yond these ocean-lakes, the average
isotheral and
catarrh and influenza is
1ing into the interior be-
rises in proportion as the
isocheimal lines tend to opposite directions.
the other
divisions
the same
law obtains.
On the
Atlantic
coast, between the Delaware and Savannah Rivers, the annual
ratio
is 271,
while
average of the
interior
posts of the
Middle Division
their south than
, notwithstanding this class lies somewhat far-
the former, is 290.
As most of the
posts of
the first class of the Southern Division are on the Lower Mis-
eissippi, and are much
water, the
annual
under the influence of large
ratio is as low as 218
while
t
bodies of
he second
class,
which comprises the mild,
insular climate of East Flor-
ida, has
an average of
only
143."
thus see
that
large
bodies of water modify climate
favorably, and
that the ratio
of pulmonary disease increases with the increase of the mean
annual
ranges of temperature as regards the seasons, rater
than
prevalence of sudden
or diurnal
vicissitudes
that the injurious effects of moisture, even in cold climates, are
more than counterbalanced by the modification of the temper-
nature of the air induced by the warmth of the water
while
warm
climates, in
winter,
moisture
has a
positively
beneficial effect in limiting the diurnal vicissitudes.
As regards liability to disease in
Florida, a careful
exam-
nation
of the
" Medical
Statistics of the
Army," extending
through a long series of
years, personal
observation, and con-
versation with medical officers engaged in the Seminole
indicate a remarkable exemption, throughout the State,
War,
, fiom
malignant
with
or even
very
the exception
serious
diseases.
Northern
"At
Division," says
seasons,
Forry,
"the mortality is lower in East Florida than in any other elam
of poets."
He ascribes this, in a great measure, to "itt being
nearly
wholly
a state of
Nature."
Oircumstanoep have
hLanged since then,o of oure, and the oleariug of the Anert,
especially the hammock, ha developed in the sunear w n
a n-naiAamnhla In n an nU fwv
N MelthaahhfVf r Mti
*wa~L
I
I
I%
h .L
sive exposure and fatigue endured by onr troops in the Indian
wars, in penetrating the swamps and Everglades in pursuit of
the savages, the
'amount of serious
disease
developed was re-
markably small, and the ratio of mortality, as Forry has shown,
correspondingly so-only twenty-six per 1,000;
while in other
portions
United
States
was
Barnes, our present Surgeon-General,
thirty-five.
informs
the
on one occasion he accompanied a boat-expedition
General
writer that
through a
portion
of the
constantly wet, t
eating uncooked
alarming the en
Everglades,
making
, although
their
food, being
way
they
at night,
afraid to
light
were
for a
fires for
Most
time
ear of
emy, no severe cases of fever or rheumatism
were
developed in
the detachment.
General
Crane, the AA-
sistant Surgeon-General,
gives similar testimony from his own
experience.
In the "Statistical
Report of the Sickness and
Mortality
of the
United States Army," from 1855 to 1860, is a table, at
page 163, which exhibits the sickness and mortality among the
troops
stationed
at the
especially as regards the
interior
Gulf
posts, and
former, the most
embracing,
unhealthy part of
peninsula.
The
number of
cases
whole
year is
19,312, the deaths 119, or 0.61 per cent. There were but four
cases of congestive fever, none of which died. It could there-
hardly have
been of
the severe
character which is met
with in other parts of the country.
If we take into considera-
tion-the very unfavorable circumstances surrounding the small
commands scattered over this area, the
bad water, poor food,
hard work, and continuous exposure of all kinds, the small per-
centage of mortality is remarkable, and shows that, although
the cases
reported
for treatment are very numerous, the dis-
eases of all kinds were very amenable to treatment and rapid
cure; as all the military operations went on successfully
not-
withstanding this very
large amount of
sickness.
The very
small
percentage of deaths from
diseases
of the respiratory'
organs is especially noteworthy--only thirteen
case
among
the 19,000 of all diseases treated.
Notwithstanding the damp-
'ne, rait, and exposure, there were olily.thirty-three case of
a
wemtwk and
twenty-five of Dneumonia.
"I have served in
D. 8. Yulee, United Statee Senate, October, 1866M
"and
have
served
also with an army on the Northern frontier, and, from
my experience of the
influence of
climate
active opera-
tions in the field on the health of soldiers, I have no hesitation
in expressing the belief that, had the troops engaged in the
Florida War been engaged for the same length of time in ac-
tive operations, in winter and summer, on the frontiers of Can-
ada, though the cases of
disease might have
been less numer-
oue, the mortality would
have
been
infinitely- greater, than
was experienced in Florida."
Tourists are industriously warned, by persons interested in
other localities in Florida, against the malaria of the St.
River.
is undeniable
that
persons
do occasionally
John's
suffer.
from it during the winter season.
except to those who
But it rarely gives trouble
are unusually careless in exposing them-
selves, or in drinking well instead of
cistern water.
The State abounds in springs of
excellent water, but
they
are not always accessible.
Rain-water, however, may always
be had, even in the driest seasons, by providing
large cisterns
storage.
Lately,
water
been
procured
bor"jg
through the calcareous crust to the depth of sixty feet or more,
and the water, when filtered, is pleasant to the taste.
A quali-
tative
analysis
one of these wells in the yard of the Put-
nam House, made by my friend Prof. Witthaus, gives the fol-
lowing result
bonate)
Lime (carbonate and sulphate); magnesia (car-
ammonia, soda, chlorine, carbonic acid, sulphuric acid-
(traces); silicic acid
tity.
organic matter; the latter in small quan-
This water ought not to take the place of rain-water for
drinking-purposes.
occur in
The cases of intermittent fever which do
the winter, generally among those who are visiting
different points of interest up and down the river, and more
or less exposed at night, are very manageable. It is not fair,
however, to attribute every case of fever, which occurs among
Northern visitors, to the Florida climate, since the disease has
been so very prevalent, almost over the whole of the Northern
States during the last five years, both in winter and summer,
that it would
more
rational to
attribute the outbreak to
latent disease contracted at home, and developed, as ia ohL-
_1
i
-- I
4. ,
V
X'i ',i **** .
r
offered from it for 'moe than eighteen months, had
failed to
get relief from a hammer's residence in Saratoga Springs, and
have never had an attack since my arrival in Florida last De-
member, though I remained
there
until the 10th of May, and
although the
winter was
an exceptionally favorable one for
the development of malaria, owing to the drought.
Dysentery and diarrhSq of
a mild type, and easily man-
aged,
occasionally attack the winter visitor.
Statistics, which
have
space
quote, show
that phthiis
gives
deaths than in any other portion of the United States.
fewer
Yellow
fever, even when it appears
in other Southern
States, rarely
appears in Florida,
except at Key
West and Pensacola.
It is
almost unknown in East Florida.
time,
fever
," says
Forry, alluding
has prevailed
" This
is only the second
bt
Augustine,
city for. twenty
" that
years;
yellow
while, at
Charleston,
we are told by
Prof. Dickson that in
twenty-four
years' practice but
three have passed without his knowing of
the occurrence of yellow fever.
As regards the essential cause
of yellow fever,
we still remain in the dark.
It is
manifest,
however, that, to develop tile cause, and to keep up its action,
requires
a high
range 0of
atmospheric
"temperature
and,
this condition seldom attains on the coast of Florida, it would
seem
afford, in
part, an
explanation of its
infrequent ap-
pearance in this region."
Wh'o should go to Florida ?
When one thinks of our cold
weather at
June, with
North
last tt
, extending from
three
months
October
of alternate
almost into
freezing and
thawing, cold and damp, with their attendant crops of
influenas, diphtheria, pneumonia, etc., one is disposed
colds,
to an-
swer,
"All
who
afford
The
mass
of visitors,
who
now pour into the. State to enjoy the winter, are
not invalids
the strict sense of the
term;
many
of those who
are in-
valids are not perceptibly so to the general
observer, and
avenge tourist is not therefore annoyed, as he feared he might
b., by constant
contact with
suffering people.
com .of the invalid clam, those afflicted or threatened with
$ fl~huU and its allied affections constitute the majority of the
to'all southern climates.
Although I do not coun-
(''r praetel of banishing those in
the last stage df
Yh ^
,,
"- t ..
C' ,
\ -r ," ^ '
4
,
A' .
the disease from friends and the comforts of home, yet, as has
been before stated, not all of\ those die, and an apparently
rash and hopeless determination of a patient, perhaps in oppo-
sition
physician and
friends, occasionally reeslts in
cure.
Besides, a considerable
margin
ought to be left for a possible
mistake
in diagnosis.
Our
first-class
diagnosticians
would
hardly require this margin, and many who do not come within
this category
winter's
experience
doubtless resent
in Florida
this insinuation.
among
invalid
But a
visitors
would convince the
most skeptical
that modern
diagnosis of
pulmonary complaints, even
professional
among those who stand high in
estimation, has not arrived at the degree of per-
fection usually accorded to it.
Then
there is a class of cases
which
here,
would
greatly
benefited
which is not considered
winter's
of sufficient gravity by
residence
many
physicians to be banished from home
those who present some
rational
symptoms
of phthisis
without
physical
signs--a
condition
unfrequently, at the present day,
con-
founded with
the effects of malaria-such cases as Dr. I.
Pollock had in mind when
phthisis,
" Here "-that
he said, in
where we
his recent lectures on
have
union of sub-
febrile symptoms with progressive waste of the body-is danger
without any physical signs."
Incipient phthisee, pneumonic
consolidation, laryngeal and pharyngeal diseases, have sought
and obtained great and prompt relief from this climate, espe-
cially
hereditary.
Many
oases
of throat-disease are,
however, sent
here
for the local affection, who have the seal
consumption already stamped on the countenance, yet who
are in ignorance
any constitutional
disease, and who
come sorely disappointed at the slow progress, and
hopeless
nature,
of the
case.
thoracic
ometimee
diseaeee,
chronic
most certainly
benefited
rarely
by
confounded
Southern
with
winter.
phthisis, is
AthAma is
benefited
, but to what extent, and in what particular localities,
I am not able to say.
It has been
claimed by invalids that a
locality back of Mellonville or Sanford, on the river, is particu-
larly efficient.
Forry states that
patient who is sauff-
- -.... .. I! -. _. -t- .t-- -.ar----. La
?V
, '*
bronchitise,
A
'U
A
A
*1
mary irritation in other viscera, is mnch benefited; a]
ma connected with affections of the heart. But he (
advise any particular locality. The earlier stages of
disease may be more successfully treated here than in
Iso
Ioes
asth-
Bright's
thle in-
clement
cially
weather of
those
Northern
a delicate
latitudes ;
constitution,
also persons,
convalescing
espe-
from
measles or
scarlatina, particularly when
kidney or other sequel
affection
are slow in passing away.
i of the
Old age
finds
Florida a congenial winter
home.
Aside from
dangers of thoracic disease, to which this
period of life
S so
peculiarly liable in our Northern
spring climate, the vitality
is impaired by the long winter and lagging spring.
this class of the male sex are also suffering from v
Many of
,esical and
prostatio
disease ;
induced by cold,
impairment
causes much suffering, and
cutaneous action
hastens an
unta-
vorable termination. Many cases also of the other sex, whose
vitality has become impaired by chronic uterine disease, and
whose local ailments have been relieved
, as far as possible, by
local treatment, find a no less invigorating tonic in thip balmy
air.
JRheumatism and some forms of
Certain forms of dyspepsia, particularly
nervous dyspepsia,
neuralgia are benefited.
y such as may be termed
which is, like other nervous affections, be-
coming more and more common-which is merely one of
many symptoms
of modern
V
often relieved completely, for a
year I
time
tear," and
, by the
which
bromides,
when
various other treatment has failed-are permanently relieved
by a winter's residence
here.
Lastly, Florida offers
a haven
quiet
for that
condition
which is
unfortunately
becoming so prevalent among the restless, driving denizens of
Northern
cities
towns, which comes under the com-
prehensive designation
nervous prostration ;
what Hand-
field
Jones terms cerebral
scribed by James Johnson
paresis, and
which
was
nearly fifty years ago
thus de-
' "There is
a. condition of body intermediate between sickness and health,
but much
nearer the
former'than the latter, to which
unable to give a satisfactory name.
daily and hourly
S4"tI .-- aS A
1.,,
--_ *' ML 1 .... 1'_1__ _J PIt- __ l q -- 1 .. I l _
A
-' I
S '
,,>h
:'Z
felt by tens
the empire;
of thousands
metropolis and throughout
but I do not know that it has ever been described.
It is not curable by physic, though I at rehend it makes much
work for the doctors ultimately, if not for the undertakers. It
that
WEAR AND
TEAR
of the
living
machine, mental
corporeal, which results from over-strenuous labor or exertion
of the intellectual faculties rather than of the corporeal pow-
era, conducted
in anxiety of mind and in bad air."
For this
cerebral
consumption,
we may
it, Florida affords as
soothing a
balm
as for
pulmonary variety.
It is as un-
satisfactory to
and exciting
treat
atmosphere of
as the other in
the stimulating
our Northern Babylons.
There,
everything is energy, hurry, and rush,
at all times and at all
seasons;
when
body is at
tendency is always
mind is
in the opposite direction.
)t. Here,
Here, the
Northern blasts, as they approach
our borders, are gradually
hushed into whispers. The
along their rocky beds as if
re, the very streams seem
afraid lest winter should
to rush
congeal
them
before
they
reach
their
ocean-goal;
here, the swiftest
currents have
not enough
energy to form a ripple.
ture wears so subdued and peaceful an aspect, as one floats on
broad
placid
bosom of the St. John's, that the most
restless mind soon becomes
attuned
same
measure of
repose.
Rest
has come again
the wearied spirit, sleep
the fevered pillow.
" All that surrounds one in Florida," says
Ledyard,
" is suggestive of, and in unison with, rest;
and noth-
ing is more grateful."
When shall one go to Florida 7
This will depend on cir-
cumstances, extrinsic and
intrinsic, as regards the
and may be left to the judgment of the physician.
individual,
But, if an
invalid has only a limited winter vacation, he had better spend
it at the end than the beginning or middle. When shall one
Iave Florida or the South 1"
is a more important query.
Many
not only sacrifice all the benefit obtained by a winter residence
in the South, by yielding
to an
impatient desire to get home
too early in the spring, but are actually darrtaged to a greater
extent
than
they had remained
at home.
Even healthy
w
catarrh, by going North too soon.
One may commence getting;
homeward
in April,
tires
sameness;
otherwise,
need
not move
until May.
Virginia until the third week
ida becomes oppressive in Ap
But he should not get north of
in May. If the climate of Flbr-
ril, Aiken, or Beaufort, in South
Carolina, affords a more
bracing and, at
both the
beginning
and end of winter, a delightful change.
He should not arrive
latitude of New
York until
third
week in
May,
better even the first of
June, if. he
has actual
pulmonary dis-
ease.
How
by land and
shall one get to Florida P
by sea.
The feeble
There are
invalid, if he
many routes,
takes the for-
mer, should go by easy stages, and not rush.
The
latter part
of the
journey is so slow and
tiresome that, unless he has an
unusual repugnance to the sea, it would be better to take one
the very good
most
popular
steamers, of
being
that
which
which
there
are several
touches
lines,
Charleston
where a transfer takes
place to the steamer which goes direct
to Jacksonville
Pilatka.
Being once aboard, all fatigue
is at
an end
four days of
sea-voyage are
generally
beneficial to
our excellent
steamer, on
the dread of
pulmonary and throat affections.
signal-service
the coast, almost
many.
There
now,
perfectly
are several
render
.y safe.
The warnings
ocean-travel by
Se&asickness is
means by which
may be greatly alleviated, and
First, one may take bromide of
frequently entirely prevented.
potassium in doses of twenty
to thirty grains
embarkation.
three
This
times a day,
deadens
nervous
three
days preceding
impressions
centres, and
power of the
blunts
reflex
bromides from
action.
I was led
their efficacy in
infer this
preventing the
vomiting induced by anesthetics.
ed by Jobard, of Brussels, is, in
Then
many
the belt recommend-
cases, a valuable
ventive.
is worn
, as tightly as can be conveniently borne
(which gives less
trouble to females than
ewais, and should be shaped to fit wel
males), around the
and be
provided with
bones
like corsets.
have
Co.'a, 67 Chatham Street, after
some
Jobard's
made at
pattern.
Tiemann
His idea,
that
,it actby preventing friction of the viacera against tho.
* <4$'
:r,
'-^'C
*
-A '
'w%
As
V
,/I n 'I
-(
MS
wpay act
by the
support
vessels in the abdomen
tion
the blood-pressure
influence the semili
probable explanation
voyages have found
unar
rn,
and .compression
afforded
the great
, thus preventing or limiting the varia-
the braf ;
ganglion.
since
persons
or the pressure may
The former is the more
who
that, by managing
have
made
several
their respiration in a
certain manner, the sickness may be prevented.
That is, by ac-
customing one's self to take an inspiration as the ship descends
with the wave, and
making tile expiration
correspond, as far
as possible,
with the rise of the ship, this apparent sinking of
the ship under the
induce the sickness.
landsman being the motion most likely to
Vomiting and nausea, from a variety of
causes, are
means
, by the
frequently cured,
use of
after the failure of
electricity by faradization.
ordinary
ie writer
first called tl
effects in this
attention of
.profession to its
remarkable
respect, in an article in the first number of the
Archives
Electrology.
not had
sufficient
evi-
dence yet to prove its value in sea-sickness, but such as he
had is
favorable.
A small Gaiffe battery,
which
is inexpen-
sive
easily manipulated,
readily managed by the
patient or a friend,
one wet
electrode being
kept
on the epi-
gastrium,
the other over the spine, or rather just to either side
of it, unless it is large enough to extend across, and then over,
the seventh cervical vertebra.
How shall one live in Florida P
This question will not be
fully answered here, as it will be again taken up.
Those who
*have a fondness for out-door life, hunting, fishing, etc., and who
have the vigor to endure a little
hardship, may form a
party,
provide the necessary equipment, and, with Hallock's
" Camp-
Life
Florida "
and similar books as a guide,
dance of novelty, adventure,
game.
may find abun-
they need any
other advice, I
Ken worthy, of
have no doubt
Jacksonville, i
my friend Al-'reaco, Dr. C.
kindly furnish
to any of
his confr6ree of the profession. One may li
ing-.houses at ten to twelve dollars per week,
ve in good board-
with good rooms
in pleasant situations, but, if he can afford it, the hotels in most
place of resort are far preferable on the score of food.
This
:11"
*It ^ 1
R-
* %
^'.'
a1^^^!^4?",
I
$*** ',
food
asle .qta naon
-for the alleviation or
Full nutrition of the
in the case
cure of
which
bldy is of the
of such diseases
people come to
as those
Florida.
highest importance, and
patients should never sacrifice
to a desire for cheap board;
better to
make almost any other sacrifice.
attributed to the climate are
aspect.
probably due to
If appetite or digestion fail for
Many failures,
error in this re-
lack of inviting or di-
gestible food, and this cannot be obtained,
the invalid
had bet-
ter go North and brave the cold, if he has a comfortable home.
If possible, one should always secure a room into which the sun
shines during a considerable portion of the day, especially the
morning. sun.
beneficial to
Nothing is more cheering, and nothing is more
chronic
invalid
than
sunlight.
trees
should
allowed to intercept the sun's rays.
If too
hot, it
can
be moderated
revivified
by awnings or
by sunshine and
blinds.
light, and
sickly plant
invalid
animal re-
spends equally, if not
so apparently
to their
stimulating in-
luence.
have
banished
tile traditional
heavy and dark-
colored hangings which formerly adorned the bedsteads of the
sick.
Let us equally banish
them
from the
dows of the
sick-chamber, and admit the
to assist our tonics with wh
glorious
iat no arti
light and air of heaven
facial tonic can supply.
us endeavor to
cure
patients of
a prejudice
which
James Johnson aptly terms phoabophobia.
With regard to
the clothing proper for the winter climate
of Florida, it is seldom that the invalid will
want that which
we wear at the North in summer, but rather that suitable for a
moderate winter or late
be sometimes a
Moderately thick clothing will
little oppressive in the middle of the day, but
always
thick (
pleasant
,vercoat
or shawl
morning
.as the
and
case
evening.
A, tolerably
may be, should
always
be taken along
when
one goes
ride, or
in a steamboat, as
the rapid motion creates a draught through the saloons.
woolen clothes should be worn at all times.
Thin
A most
important desideratum
for the
invalid is ooupa-
ion--something to give employment to
both mind and body.
Want of it
stumbling-block to
*i a A. aS La a a -A
improvement and
War -- .-
1
" *
'**"* ;'^
' .'A
kt. 2
- V
^^-
employed
upon something
external,
are sure
be tunraed
upon his disease, whether imaginary or real, and usually to his
detriment. Employment, which Galen calls Nature's Phy-
sician,' is so essential to human happiness that indolence is
considered the mother of misery."' English soldiers in tile
West Indies, while idle, though kept out of the sun, and taken
care of, were far more disposed to diseases, says Robert Jack-
son. than when
kept
at moderate
labor
nearly all day long,
building roads in a marshy district.
Lanier, in his interesting
little
volume
on Florida, himself
an invalid
, thoroughly ap-
preciates the importance of this subject.
He says
" Endeavor
to find some occupation consistent with your disease's require-
ments.
interest
Brooding kills.
yourself i
If you are near a Florida farm (e. g.),
which is
going
on there, the
orange-culture, the
early vegetables, the
grape-culture,
banana
fine tobacco-culture and
like.
the
The
field of Florida in these matters is
yet so
new, so untried
the resources
modern
agricultural
improvement, as to
full as fascinating, if one should once get one's interest aroused
in it, as it was in the old days when the Spaniards believed it
to be full of gold and pearls.
Many invalids came to this spot
winter,
and, finding
nothing to
interest them, although
acknowledging *the
superiority of the climate,
wandered
in search
of novelty.
Many others, although remaining here
for many weeks, found that there were objects of interest still
unexamined when they left, although pretty industriously em-
played all
the time.
The fault, in these cases, is generally in
the individual, not in the place.
Some seek out sources of in-
terest and amusement for themselves wherever they go
others
of different tastes, or
the temptation of in<
less in
dolence.
quiring
Those
habits of mind, yield
who
have become blee
from frequent
visits
ordinary
haunts
visitors
may,
they possess
the requisite
strength and
energy,
strike
new course, and explore almost untrodden regions, and without
any particular danger or discomfort.
sands," says A.M. Oonklin, "who, each
'ih eahvtf heiti and pleasure, few if
dsrlht&1" interim country,' referring to the
"Of the tens of than-
i winter, go to Florida
any ever hear of this
Kiaeimmee and
n something
i A^
I
1
L-
I 1 I
Oceohobee region,
" which is as
little known to the outside
world as Amazonian forests, East India
of equatorial Africa."
jets of interest, there
Besides
jungles, or the
the natural beauties and
akes
ob-
are some of the most interesting relics
of the mound-builders to be found in the State.
Their location
and peculiarities are described in the December (1875) number
of the Forest and Streaom, with a map.
Visitors
last winter
found
much to
interest
them in
their visits
mounds
which are scattered along the St. John's River above Pilatka,
and their explorations
ancient art scattered a
therein.
These
remarkable
works of
over our country are still a mystery,
to some extent, to our scientific
authorities, and
an examlna-
tion of the subject, as found discussed in the many interesting
works
by Baldwin,
Jeffries
Wyman,
others, in
connect
with
the explorations and
prosecute themselves in Florida,
examinations which they can
will be found to afford agree-
* able and perhaps profitable diversion to
considerable portion of the winter.
body and
mind for a
Physicians, in sending their patients South,
frequently ad-
vise them by all
means "to avoid
drugs and
doctors."
The
same advice, at home, might'often be good for those who have
a propensity for too much indulgence in these
in some
instances,
e
saved
doubtless
uxurics (?)
invalids
here
; and
from
injudicious medication and advice.
But, from my experience
last winter, I
judge
that
a much
larger number
have
been
directly injured by it, and, not infrequently, it has cost them
their lives, through neglect of the early treatment of serious
complications. Any physician in large practice in Florida, or
any boarding-house keeper, can furbish instances of this kind.
There
is no prominent
resort
in Florida
where respectable
medical advice cannot be had-advice .which would
certainly
* be far
better than the usual
plan of trusting to
luck or
ture, or the advice of lady-friends, or the carefully-put-up bot-
ties and
packages
brought
from
North
indications for treatment which may chance
long winter. Upless the medical knowled(
skill could also be bottled up to accompal
meet all
to arise during a
diagnostic
SI I I
--11 La 1I*tal-m dmA na a A ^nlnan anti a andre FnrW MC'iKMft&.M
* *^
*-,
l
' '' '- *'
Y'1 1*?
- *.
t
ge
ay tabe I sthey
j> 4rnI.A
tion of
a serious complication, or of a disease, for some simple
derangement, ie too great, much greater than
that of
getting
medical advice ;provided
inquiry is
made for the
best.
Besides the local physicians, there are now, always in all fre-
quented places, medical
trv. well known to the
only
one
instance,
men from other portions of the coun-
profession.
in illustration
The writer
of many
will refer to
which have
fallen under his observation.
A well-known physician of
one
largest
Northern
cities
accompanied
patient
Jacksonville the;past winter, and introduced him
nent
physician
of that
place.
Subsequently, the
to a promi-
latter was
called in
, and found that the gentleman had, from some impru-
dence, taken
a severe cold
a few
days
before, and had been
endeavoring to
get along the best way he could without med-
advice.
He said,
"Doctor, I don't know if I
have
done
right in sending for you,
for Dr.
charged me not to send
for a
physician ;unless
was absolutely
disease proved to be capillary bronchitis,
irremediable even if taken
at the onset.
necessary." The
which is frequently
He was in a hope-
less condition, and died within
twenty-four
hours.
Another,
scarcely less
serious, and
even
writer's opinion (one, indeed,
more
to which
prevalent error,
we must
in the
a cer-
tain extent, plead guilty), is, concealing from the invalid, and
even also from the friends or relatives, the true nature of the
disease.
This entails
unpleasant
consequences
both
on the
profession and the patients.
The true pathological
condition
not being stated,
the different
physicians
who
may be called
in at different
times
to examine
the case are not
apt to
upon the sa:ne statement,
and
thus
public
berate
us for
disagreeing, and the science of medicine is scandalized, or our
honesty is
is a little
impugned.
weak;"
of this lung ;"
One says to the invalid,
another,
another,
" There
" There
" Your
lung
is a little pleuritis at the
is some consolidation at
the apex; "
"The
air does not enter quite as well in
one
dif-.
lung as in the other;"
culty;
"The tubes are
" There
is a little
slightly affected."
bronchial
Often
" chronic
& A
:':4,
, pqWQPS pilB
diagnosed.
If there
Shu b
een
hanmourhags
It.
.% si.,, I
%
,/
Ii: *
*^'
our
. I.'
E~y;;t~
;* 4r,
241,
with his explanation to
my throat, I suppose ? "
he physician
The doctor
that "it is only from
says, Posedby it is,"
and fails to
that it isn't.
physician
undeceive him when he finds, as he usually does,
Then the patient tells his
that
his "
second
doctor" says it is only in his
and his third
throat, and
the other physicians wonder, perhaps, how so eminent an
thority could make so glaring a blunder.
tions
are literacy true, but they are
Now, all these asser-
the zokot trutk; in
fact, but a very small part of it.
A medical man knows what
a "little weakness in one lung signifies, but the patient does
not;
or t
or a little pleurisy at the apex; or a consolidation,"
he
little bronchial difficulty," etc.
nineteen
cases out
twenty,
incipient
knows it means
phthisis--" con-
gumption."
But the patient does not, and he is very sure not
to cross-question the doctor too closely, if
at all.
He is only
too glad
have
comparatively
his fears
trivial
allayed
secondary
so easily.
affections,
Behind
there
these
is often
tubercular deposit, or, if
pneumonic consolidation,
already a cavity.
sive softening in
one prefers to
qr softening;
Many patients come t4
one or
both lungs,
call it so, permanent
or, not unfrequently,
, Florida with exten-
with
the consent, if not
the advice, of their physician
truth,
to crush
bright
who dreads
to tell the
anticipations of
cure,
whole
which
they and their relatives have formed,
through the instrumentat-
ity of the climate of
this favored region,
which they have
heard so
much
and, perhaps, hoping that, at least, a
tempo-
rary
progress
the disease
may
be obtained.
When an early death occurs,
with none, perhaps, but strangers
around, and
body is, according
to custom
sent
home by
express,
Florida.
then
the physician's
reputation
If he is right, Florida is wrong.
suffers,
or that
Florida can-
* not work miracles.
the threshold
It is
, by
true, the physician
friends of the invalid
is often
with
met
the c
tion, and often
quasi command,
"Don't tell
her she has con-
sumption-it will kill her if you do
the contrary,
One may wel
" It will kill her if you don't."
theeffects of the deception
are far worse ti
say, on
In the long-run,
ian those of the
-.,
C
au-
h
~*~Zt A
while the latter are transient, though, no doubt, at times di-
treeeing and severe.
matter
nings of the disease may be, the
should say to the patient, "You I
how slight, then, the
begin-
moment we are certain, we
have what will result in con-
sumption '
without proper management."
fait,
in most
cases, we can say,
" You have the beginning of
consumption."
the announcement is made
min a proper
manner,
which
the physician's tact
idiosyncrasy of his
neutralized
other state
will enable him to vary according to
patient, the
shock is
slight,
, and the patient's confidence reassured,
ent
that,
with
due care, and
proper
Id entirely
by the fur-
hygienic and
remedial
measures, the
disease can
be cured
just as certainly
as many other diseases.
superfluous attempt, at
It would be a
this "epoch
waste of
of medical
time, and a
history, to un-
dertake
sidered
reason
chronic
prove this.
for this.
Consumption
always
medicorum.
Consumption is
affection-more so
than
as curable
many
been
con-
there is no
as any
them,
other
we can
command
himself
curable
d
the conditions
of cure,
of the proper remedies.
without
patient
avail
Most diseases would be in-
a resort to the proper remedies.
so hap-
pens, however, that most of the best remedies for this disease
are unattainable by tihe majority of those afflicted by it
that
most
patients,
influenced
delusion
which
also,
is so
characteristic
a symptom,
often
by the
concealment of
physician and friends, delay treatment.
ity. The cure of phthisis will never be I
any combination of
indeed
drugs, although
thee
, in most cases, indispensable auii
Hence its great fatal-
found in any drug or
ie are valuable, and,
liaries. There is no
disease, in which skillful diagnosis, sound judgment, judicious
advice as to habits, occupation, climate, all the minutim which
enter into individual
daily life, are
so well
repaid
by corre-
spending success as in this.
Change is generally the key-note
to our management of incipient phthisis-change of locality,
of air, of almost all the habits, leaving off bad and adopting
good; wntilabtwn rs e (judiciously managed),iuod. Now,
it wbuld be mockery almost for
ns to
say to the
poor
sdoe-
.i~raik a- 1 .
- z S- -
of the opprobria
L1 _,I_ _L L.. ~: !e ,I
7" -.'
* /
'A
r^ I
with its
confined
sea or the farm, to
nd poisoned a
out-door work
food, sound wine, fewer hours
only
remedies,
alternative.
we- must
do the
When
best we
hygienic rules as can be observed.
You
must
and regular
work," etc.
we cannot
can.
take
to the
exercise, good
We are driven
et the proper
prescribe such
We prescribe cod-liver oil,
,I
r-S
' +'
phosphorus
compounds,
palliatives
cough,
etc.,
and we thus lengthen and render more tolerable
cannot save.
stances,
we do
lives we
Sometimes, even under these untoward circum-
p save life. All do not die, by any means. The
physician who, at this day, consigns
to the realms of despair even in the
the disease, without an effort to save
consumptive
patient
more advanced stages of
him
, scarcely appreciates
his mission to its fullest extent.
* Suppose, then, that our inva-
lid knows that he has incipient consumption, or that condition
of lung, call it by whatever name you will, which under ordi-
nary circumstances
almost
surely
result in
actual
con-
sumption.
chance fo
those
able
He is cheered by the confident assurance that his
complete
to avail
recovery
themselves
is good
are speaking
of our advice);
that,
at all
events,
greatly
if he
does
prolonged.
completely recover,
But,
understands
may
that
is, so to speak,
in his own hands
that he must, in a measure,
work out his own salvation.
He knows that he banishes him-
self from home, perhaps from friends also, to make a fightbor
4fe.
He ought to know, likewise, that the fight
a short one;
is not to be
that perseverance is necessary, and a patient
quiescence in all the minute of the
advice
of his
physician,
however muck and often it may conflict with iis oishes and
his temporary pleasures.
Without this knowledge, it is almost
impossible to get the patient to avoid the most outrageous in-
fractions of the most simple
rules.
The physician
must
that his
patient
is not hampered
by too
much
advice
and too strict roles.
nual character come
signment to the ba
Here, judgment and a study of
into play.
okwoods, to
Some patients may
interior
1
individ-
ear con-
pine-regions-no
K.nk aa As da* L. ni a.- me -,t,,414,,wa
'^*i*^^ ^-r -'
.,
*' v
w
,''. *
^
L
1 (
Nn
arr-rrrl-irr
mnra
:.>^
-4.
'.4,
~s., -~U-
moisture or dryness, are to
for
tion
individual
s, diversion
patients
be considered in
congeniality, am
thoughts
from
making a choice
usements,
within
, life,
occupa-
activity,
facility of access to and from the outside world.
But, suppose .the
.disease
is not incipient.
Suppose it is
advanced
that it involves a considerable
portion of the lung,
that softening has commenced, even an abscess exists.
be asked
It may
" Would you still inform a patient of his condition "
To a certain extent, yes
dividual.
involve
How far,
would
There are exceptions to all rules.
more
stringent
rules
advice
depend on the in-
Such conditions
than
milder
cases
few patients will
disposed
atfall times if they are not impressed with
submit to them
3 necessity, and
they cannot be so impressed if they are told that nothing very
serious
exists.
The general condition of
many of these-the
appearance,
figure, the
muscular strength,
appetite,
the sleep, the ability to sustain
considerable fatigue-may be
good, or quite fair ;
it requires no small degree of
confi-
dence in a physician to convince such
edition is such as to demand so close an
invalids that their con'
adherence to hygienic
rules.
Even if
usual
debility,
cough,
emaciation,
exist
the delusion
which is an
almost
*inseparable attendant
on the disease, prevents the invalids from realizing the mean-
ing of
these symptoms.
Being in
Ignorance of their condi-
tion, they are constantly wondering why the cough cannot be
' stopped;
be arrested
they do n<
" why the hoarseness or soreness of
throat cannot
why the expectoration cannot be checked ;
)t gain flesh
whom they look upon
why
or strength more rapidly, like others
as afflicted with the same form of dis-
ease.
physician
kept them in
ignorance of their
condition
, he cannot explain himself satisfactorily; his appar-
want
success impairs confidence,
they
apply to
some other
, in going from one to-another, and from one
location to another, and
thus
undergoing a succession of ex-
periments with various drugs and various climates, they lose
the only hope,
Some of thi
which is in a steady perseverance.
e reasons toa iwacids fail to a
r Mte cM-
ir:,
I -
I
Y Y
"'* v .
,r *<
-;y'A
*/i\"l
r* a o* f.
tl", ,
fl"ff
proper appreciation of their condition, and of proper advice,
leading to
recklessness
want
of proper care.
want
fact, the
common-sense
extent of the
exhibited
many invalids would not be believed by any one who had not
observed it.
Even
remonstrances of friends seem to in-
fluence them but in
ander
a trifling
Mitchell, of Villa
corroborate this
degree.
Alexandria,
statement, as
My friend Mrs. Alex-
near
almost any
Jacksonville, can
observing person
jl
\.
r^*
4 *
here
can.
beauty and
Her hl
tasteful
house
grounds
adornment
affording,
from
their
, a source of pleasure to visit-
ors, she is sometimes almost
overwhelmed
by them,
related numerous instances of the temerity of invalids, ladies
especially, in
coming
over in
frail
sail-boats in the most ii-
clement weather, and clad
in tle most
sometimes arriving drenched with
unsuitable
spray or ram.
garments,
On one or
occasions
them.
to send
In fact, her experience teaches
boats
her that, if there
rescue
is a
particularly
unsuitable
visitors
venture
water,
must
expect a
batch
of invalids.
Her
kind
monstrances seem to
be entirely unheeded,
the same
invalids
not unfrequently repeating the operation.
Instead of getting
the best advice as t
able length of time
location
testing
remaining there a reason-
it, they remain
a day or two,
, if the weather happens
to be unpropitious,
or the
hote
table not precisely what it should be, or the company not par-
ticularly agreeable,
or the
evenings
, off they
another experiment,
all winter.
thus traveling from one place to anot
Suppose they find a place which they cannot but
acknowledge
commodation
be all
, fare, etc.
they
One
could
would
expect as
suppose
climate,
that any
invalid would be glad to remain there.
" I am getting
tired of this
place."
"My
is so dull."
daughter
don't
enjoy
)r, "My
herself."
wife d
And
they go in search of variety and excitement.
Life and health
weigh lightly against matters of such magnitude as these
party is
made
when
the weather
is tine, to go
to some
lake or stream on an
excursion.
When the hour arrives, the
S *t S U.
"
-V
^.
sane
* I*
r ->* 5:
-, ^\!' ,*
*
q
* J
tIt~~s ~.
*'itt
-X~ ',d-rr (
- "
think of going."
to protest against
Not so.
any
They are
postponement;
knowing anything about it, that the
usually among the first
wind
asserting,
will soon
without
change
and the day be pleasant.
that is to be seen. The'
the boat,
where
view
Many, on the other hand,
any competent medical a
' And then they must ses everything
r must stand
is best, and
come to one
advice, do
in the forward part of'
the draught is worst.
locality, and, without
stay a
whole
winter, get-
ting worse all the
is good, the music
daughters, and tl
while.
is fair, there
iey
are hoping
they like the
are frequent
place, the room
"hops for the
time to get
better.
Then
, when spring
comes, they go home, and condemn ria,
as if the whole
State, like
France,
were represented
one
city.
instance,
Miss M.
, and a gentleman-friend suffering
from lung-trouble, went to Sarasota Bay, then to Manatee, on
the Gulf
coast.
They were out of
the world and uncomfort-
able, a
mained
getting
rather
worse
than
better.
and, in order to get away in the
they
spring, had to pro-
ceed
some
miles
in a small
boat to
the coast to await
uncertain
arrival
of the
little steamer plying to Cedar Keys.
And
here
they
were
exposed
naturally rather "disgusted with
* two days;
'Florida.' "
both
Again,
the in-
valid, o0
nothing
n the way down
more
likely.
in the cars
The cola is
takes a
neglected,
slight
"cold ;"
it gets worse;
cough
increases,
nights
are thus
made
restless
sleepless, the appetite fails, there is some fever.
or mother gets nervous. "The climate don't a
haps they go home again, or go to St. Augustir
or Jackson v
The husband
gree," and per-
ie, or to Aiken,
le, or Pilatka, or somewhere else, anywhere ex-
cept where they ought to go, that is, to a competent physician
for advice, as to what they should do.
be required,
little judicini
A suitable change may
or perhaps only a simple cough-mixture,
us
nursing is al
that is required to give the cli-
mate a
"fair
show."
Sometimes
change
water
climate causes a diarrhea, or it may set in as one of the acci-
dents of the disease.
It is a simple matter if managed in the
ft .
.* *i i) "
d
1
A q ,
k4 '^
Sr 'f
p ., .
'" con sults a friend.
Another is
" sore."
She has a specific,
This
don't
succeed.
course; t
Finally,
fails.
perhaps
after considerable damage is done, a physician is consulted as
a dernier resort.
Loss of
appetite is a not unfrequent corm-
4 -. ,y
r J > *
tk.^ ,
4
:-'1_
plaint among this class of invalids.
But this is endured
worried about, and friends are again consulted,
and "bitters"
are recommended, and
the winter is
thus wasted to a consid.
erablo extent.
It is a very common
occurrence, and
one of
the'greatest nuisances of Southern watering-places in winter,
for patients
sometimes,
lose their sleep, night after night,
with
a most
severe
persistent
weeks
cough,
seemingly not to be aware of it.
At all
events, they consult
no physician ;
distress
insomnia,
other
troubles arising from it, sometimes completely counterbalance
any good
Hotels s<
effect
they might
)metimes
have
derived
some of their
from
families ii
climate.
a conese-
quence of one person on a corridor coughing night after night.
It would be tiresome to multiply these examples. One might
adduce scores.
They are
mentioned
as a hint to those who
may
benefited
by them.
They
are not,
;ny means,
overdrawn.
The writer is willing to
the suspicion
that
he may have a selfish object.
Those who know him will give
him credit for a
better motive.
The following remarks, of
writer
than whom no one is
better qualified
give
advice
on this subject, are so appropriate in this connection,
that they
ought to be quoted at length
"Let not the invalid
, however,
trust too much to a change of climate.
Unfortunately for the
character
criminately, and
remedy,
without
been
recommended
proper consideration.
indis-
been
often
resorted to as a last resource or a forlorn hope
in cases susceptible of
alleviation
or permanent cure, it has
been
wholly
misapplied.
One
person
is hurried
from
native
land
with
certainty
of having.
sufferings
creased, and his life shortened
, instead of being allowed to die
in peace in his own family;
while
another, who might derive
much advantage from
the change, is sent abroad wholly un-
instructed in regard to the selection of
proper residence, or
- -a a a -S -
id it
;''* .'"
1 '^
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A
suitable climate can be rendered beneficial.
.It is one of
our
most powerful
remedial
agents, and
too which, in
many
oases,
admit
no substitute.
But,
much
permanent ad-
vantage will result neither from
traveling nor change of
mate, nor their combined influence, unless the invalid adheres
strictly to such regimen
edy-change of
as his case
climate-must
may require.
considered in
This rem-
the light of
all other therapeutic means, and, to insure its proper action, it
is requisite
that the necessary conditions
observed.
The
patient should, in a measure, regard the change
of climate as
merely
placing
him
in a situation
more
favorable
operation
remedies demanded by his disease."
These
remedies, whether local or general, or both, though ineffective
in a northern
climate, may become
curative when
aided
the healing influences of a southern climate and out-door exer-
cise and employment.
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